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Organization
J C PURNELL MD SC
Active
Organization
J C PURNELL MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C PURNELL (OWNER)
(815) 842-1166
Entity
Organization
Contact information
Practice address
401 E WATER STREET, PONTIAC, IL 61764-0470
(815) 842-1166
(815) 844-5968
Mailing address
PO BOX 470, PONTIAC, IL 61764-0470
(815) 842-1166
(815) 844-5968
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05300058
BCBS
IL
Enumeration date
11/24/2006
Last updated
10/05/2007
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